indication

Used in preventing and treating iron-deficiency anemia.

pharmacology

The major activity of supplemental iron is in the prevention and treatment of iron deficiency anemia. Iron has putative immune-enhancing, anticarcinogenic and cognition-enhancing activities.

mechanism of action

Iron is necessary for the production of hemoglobin. Iron-deficiency can lead to decreased production of hemoglobin and a microcytic, hypochromic anemia.

toxicity

Acute iron overdosage can be divided into four stages. In the first stage, which occurs up to six hours after ingestion, the principal symptoms are vomiting and diarrhea. Other symptoms include hypotension, tachycardia and CNS depression ranging from lethargy to coma. The second phase may occur at 6-24 hours after ingestion and is characterized by a temporary remission. In the third phase, gastrointestinal symptoms recur accompanied by shock, metabolic acidosis, coma, hepatic necrosis and jaundice, hypoglycemia, renal failure and pulmonary edema. The fourth phase may occur several weeks after ingestion and is characterized by gastrointestinal obstruction and liver damage. In a young child, 75 milligrams per kilogram is considered extremely dangerous. A dose of 30 milligrams per kilogram can lead to symptoms of toxicity. Estimates of a lethal dosage range from 180 milligrams per kilogram and upwards. A peak serum iron concentration of five micrograms or more per ml is associated with moderate to severe poisoning in many.

absorption

The efficiency of absorption depends on the salt form, the amount administered, the dosing regimen and the size of iron stores. Subjects with normal iron stores absorb 10% to 35% of an iron dose. Those who are iron deficient may absorb up to 95% of an iron dose.

drug interactions

Ciprofloxacin: Formation of non-absorbable complexes

Clodronate: Formation of non-absorbable complexes

Demeclocycline: Formation of non-absorbable complexes

Doxycycline: Formation of non-absorbable complexes

Etidronic acid: Formation of non-absorbable complexes

Gatifloxacin: Formation of non-absorbable complexes

Gemifloxacin: Formation of non-absorbable complexes

Grepafloxacin: Formation of non-absorbable complexes

Ibandronate: Formation of non absorbable complexes

Levofloxacin: Formation of non-absorbable complexes

Levothyroxine: Iron decreases absorption of levothyroxine

Methyldopa: Iron decreases the absorption of dopa derivatives

Minocycline: Formation of non-absorbable complexes

Moxifloxacin: Formation of non-absorbable complexes

Mycophenolate mofetil: Oral iron decreases the absorption of mycophenolate-mofetil

Norfloxacin: Formation of non-absorbable complexes

Ofloxacin: Formation of non-absorbable complexes

Penciclovir: The multivalent agent decreases the effect of penicillamine

Tetracycline: Formation of non-absorbable complexes

Trovafloxacin: Iron may decrease the absorption of orally administered Trovafloxacin. Administer Trovafloxacin 2 hours before or 6 hours after a dose of the iron containing agent to minimize the interaction.